|
Infectious agent nucleic acid amplified probe
|
$158.40 |
$158.40 |
$158.40 |
$270.80
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$232.80 |
$232.80 |
$232.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$109.50 |
$109.50 |
$109.50 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$687.90 |
$687.90 |
$687.90 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$207.90 |
$207.90 |
$207.90 |
$183.41
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$67.50 |
$67.50 |
$67.50 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$94.50 |
$94.50 |
$94.50 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$60.60 |
$60.60 |
$60.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$136.80 |
$136.80 |
$136.80 |
$217.80
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$61.20 |
$61.20 |
$61.20 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$91.50 |
$91.50 |
$91.50 |
$109.20
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$115.20 |
$115.20 |
$115.20 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$338.70 |
$338.70 |
$338.70 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$201.90 |
$201.90 |
$201.90 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$529.20 |
$529.20 |
$529.20 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$160.20 |
$160.20 |
$160.20 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$234.30 |
$234.30 |
$234.30 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$366.00 |
$366.00 |
$366.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$163.80 |
$163.80 |
$163.80 |
$375.00
|
|
Initiation & management bipap/cpap initial day
|
$444.30 |
$444.30 |
$444.30 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$5,168.00
|
|
Inj., aristada initio, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$4,052.45
|
|
Inj cefazolin (wg crit care)
|
$66.32 |
$66.32 |
$66.32 |
$17.00
|
|
Inj, clindamycin (baxter)
|
$145.42 |
$145.42 |
$145.42 |
$48.96
|
|
Inj, cyclophosphamd, sandoz
|
$541.80 |
$541.80 |
$541.80 |
$735.20
|
|
Injection, edaravone, 1 mg
|
$5,139.29 |
$5,139.29 |
$5,139.29 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$671.70 |
$671.70 |
$671.70 |
$1,149.13
|
|
Injection, fulvestrant
|
$4,362.86 |
$4,362.86 |
$4,362.86 |
$1,719.16
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$671.70 |
$671.70 |
$671.70 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$594.00 |
$594.00 |
$594.00 |
$1,045.65
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$153.60 |
$153.60 |
$153.60 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$887.70 |
$887.70 |
$887.70 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$639.60 |
$639.60 |
$639.60 |
$1,004.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$887.70 |
$887.70 |
$887.70 |
$1,927.64
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,073.10 |
$1,073.10 |
$1,073.10 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$671.70 |
$671.70 |
$671.70 |
$1,685.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$113.40 |
$113.40 |
$113.40 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$113.40 |
$113.40 |
$113.40 |
$637.35
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$362.70 |
$362.70 |
$362.70 |
$166.52
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$366.00 |
$366.00 |
$366.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$541.50 |
$541.50 |
$541.50 |
$258.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$338.10 |
$338.10 |
$338.10 |
$136.00
|
|
Inj, immphentiv, 20 mcg
|
$48.00 |
$48.00 |
$48.00 |
$18.44
|
|
Inj, levothyroxine, freskabi
|
$1,635.70 |
$1,635.70 |
$1,635.70 |
$322.98
|
|
Inj, lidocaine w epinephrine
|
$318.28 |
$318.28 |
$318.28 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$703.80 |
$703.80 |
$703.80 |
$783.50
|
|
Inj meropenem (wg crit care)
|
$447.11 |
$447.11 |
$447.11 |
$77.97
|
|
Inj, nithiodote, 3mg / 125mg
|
$4,484.70 |
$4,484.70 |
$4,484.70 |
$472.76
|
|
Inj., perseris, 0.5 mg
|
$39,395.24 |
$39,395.24 |
$39,395.24 |
$5,146.85
|
|
Inj, releuko 1 mcg
|
$1,007.42 |
$1,007.42 |
$1,007.42 |
$461.20
|
|
Inj sulf hexa lipid microsph
|
$1,065.75 |
$1,065.75 |
$1,065.75 |
$256.14
|
|
Inj testosterone cypionate
|
$74.71 |
$74.71 |
$74.71 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$703.80 |
$703.80 |
$703.80 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$378.00 |
$378.00 |
$378.00 |
$818.00
|
|
Inj, tyenne, 1 mg
|
$7,755.26 |
$7,755.26 |
$7,755.26 |
$3,525.12
|
|
Inj vancomycin (xellia) 10mg
|
$380.52 |
$380.52 |
$380.52 |
$76.59
|
|
Inj vocal cord bulking agent
|
$1,956.94 |
$1,956.94 |
$1,956.94 |
$1,480.00
|
|
Insert and remove bone pin
|
$1,240.80 |
$1,240.80 |
$1,240.80 |
$4,421.00
|
|
Insert cath pleura without image
|
$726.00 |
$726.00 |
$726.00 |
$2,030.40
|
|
Insertion catheter bladder non indwelling
|
$62.10 |
$62.10 |
$62.10 |
$205.80
|
|
Insertion catheter bladder temporary simple
|
$120.60 |
$120.60 |
$120.60 |
$232.30
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,241.70 |
$1,241.70 |
$1,241.70 |
$2,511.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,159.50 |
$1,159.50 |
$1,159.50 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,840.20 |
$1,840.20 |
$1,840.20 |
$2,414.16
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,402.00 |
$3,402.00 |
$3,402.00 |
$7,216.00
|
|
In situ hybridization per specimen initial single probe stain
|
$285.60 |
$285.60 |
$285.60 |
$337.20
|
|
Insole orthotic freedom sz6 6816
|
$177.06 |
$177.06 |
$177.06 |
$84.00
|
|
Ins pq tunnld ip cath w/img
|
$3,535.80 |
$3,535.80 |
$3,535.80 |
$5,377.00
|
|
Insulin total
|
$356.10 |
$356.10 |
$356.10 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$12,300.40 |
$12,300.40 |
$12,300.40 |
$8,683.20
|
|
Integra meshed bil wound mat
|
$40,345.55 |
$40,345.55 |
$40,345.55 |
$9,924.16
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$9,278.81 |
$9,278.81 |
$9,278.81 |
$3,803.11
|
|
Interdental fixation
|
$578.40 |
$578.40 |
$578.40 |
$2,133.48
|
|
Interfyl, 1 mg
|
$5,325.00 |
$5,325.00 |
$5,325.00 |
$4,656.80
|
|
Intrinsic factor antibody
|
$272.10 |
$272.10 |
$272.10 |
$64.20
|
|
Intubation endotracheal emergency procedure
|
$458.40 |
$458.40 |
$458.40 |
$598.80
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$375.00 |
$375.00 |
$375.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$6.00 |
$6.00 |
$6.00 |
$3.75
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$13,405.50 |
$13,405.50 |
$13,405.50 |
$5,476.68
|
|
Iron
|
$296.10 |
$296.10 |
$296.10 |
$74.40
|
|
Iron binding capacity
|
$272.40 |
$272.40 |
$272.40 |
$63.84
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$118.63 |
$118.63 |
$118.63 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$263.70 |
$263.70 |
$263.70 |
$143.76
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$197.10 |
$197.10 |
$197.10 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$197.10 |
$197.10 |
$197.10 |
$158.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$197.10 |
$197.10 |
$197.10 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$335.10 |
$335.10 |
$335.10 |
$444.49
|
|
Jak2 targeted sequence analysis
|
$234.30 |
$234.30 |
$234.30 |
$405.00
|
|
Kafo dbl solid stirrup band/
|
$2,645.49 |
$2,645.49 |
$2,645.49 |
$2,185.15
|
|
Kafo dbl solid stirrup without j
|
$2,600.30 |
$2,600.30 |
$2,600.30 |
$2,276.79
|
|
Kafo fem fx cast molded to p
|
$3,894.15 |
$3,894.15 |
$3,894.15 |
$3,130.66
|
|
Kafo fem fx cast semi-rigid
|
$2,766.44 |
$2,766.44 |
$2,766.44 |
$2,130.02
|
|
Kafo fem fx cast thermoplas
|
$2,749.99 |
$2,749.99 |
$2,749.99 |
$2,710.45
|
|
Kafo femoral fx cast rigid
|
$3,027.48 |
$3,027.48 |
$3,027.48 |
$2,138.81
|
|
Kafo pla sin up w/wo k/a cus
|
$4,876.77 |
$4,876.77 |
$4,876.77 |
$4,270.06
|
|
Kafo plas sing free knee mol
|
$3,981.02 |
$3,981.02 |
$3,981.02 |
$3,485.72
|
|
Kafo plastic pediatric size
|
$415.88 |
$415.88 |
$415.88 |
$374.58
|
|
Kafo sing fre stirr thi/calf
|
$2,685.50 |
$2,685.50 |
$2,685.50 |
$2,351.38
|
|
Kafo sng/dbl mechanical act
|
$9,837.03 |
$9,837.03 |
$9,837.03 |
$8,121.01
|
|
Kafo sng solid stirrup without j
|
$2,094.67 |
$2,094.67 |
$2,094.67 |
$1,834.11
|
